Kalra 1997.
| Study characteristics | ||
| Methods | RCT Setting: UK | |
| Participants | 50 (see Notes) stroke patients with visual neglect admitted to an SU The following data are for the 47 surviving patients: Experimental: n = 24, control: n = 23 Mean age (SD), years: experimental = 78 (9), control = 76 (10) Sex (male): experimental = 11, control = 9 Side of damage (RBD): experimental = 16, control = 17 Median time post onset, days (range): 6 (2 to 14) Inclusion: infarcts; partial anterior circulation, known to be sensitive to rehabilitation on basis of impairment of power, balance, proprioception, and cognition at 1 to 2 weeks after stroke Exclusion: TIAs, reversible neurological deficits, hemianopsia, severe dysphasia | |
| Interventions | Spatio‐motor cueing based on 'attentional‐motor integration' model and early emphasis on restoration of function vs conventional therapy input concentrating on restoration of tone, movement pattern, and motor activity before addressing skilled functional activity | |
| Outcomes | Study collected 6 types of outcomes:
This review used only BI, RPAB letter cancellation subtest, and discharge home. All were analysed as immediate effects |
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| Notes | Principle behind approach: movement of affected limb in the deficit hemi‐space led to summation of activation of affected receptive fields of 2 distinct but linked spatial systems for personal and extrapersonal space, resulting in improvement in attention skills and appreciation of spatial relationships on the affected side. Personal communication supplied further data and clarification of methods No differences between groups in demographic variables or initial impairment or disability including BI Outcome data for 47 of 50 stroke patients with visual neglect admitted to an SU: experimental: n = 24 (+ 1 died), control: n = 23 (+ 2 died). For the 'destination discharge' outcome, the total figure of 50 was used in this review, as deaths were entered as not going home | |
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Low risk | Computer generated |
| Allocation concealment (selection bias) | Low risk | External randomisation, using random permuted block technique in groups of 10, allocated by telephone by clerical staff using computer‐generated random numbers |
| Blinding of participants | High risk | Not possible to blind |
| Blinding of personnel | High risk | Not possible to blind |
| Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | Independent observer |
| Incomplete outcome data (attrition bias) All outcomes | Low risk | 3 lost to follow‐up: 1 intervention and 2 control. All died, so low risk of bias |
| Selective reporting (reporting bias) | High risk | Selective reporting of multiple subtests on RPAB |
| Other bias | High risk | "Treatment of patients in each group was undertaken by different therapists of the unit to prevent 'crossover' of treatment techniques”. Impossible to distinguish effect of therapy from effect of therapists. NB: recognised as preliminary study to inform design rather than to answer questions |